Whooping cough

Whooping cough
Whooping cough is a respiratory infection caused by the bacterium Bordetella pertussis.
Whooping cough is a notifiable disease.
SPREAD B Y Close direct contact with an infected person, by droplet spread. It is highly
contagious – up to 90% of susceptible household contacts will develop the disease.
I N F E C T I O U S P E R I OD The incubation period is usually 7–10 days (rarely it can be up
to 21 days). The infectious period is up to 3 weeks after the onset of symptoms. Beyond
3 weeks, risk of transmission of infection is minimal, even if the cough persists.
I N F E C T I O U S C O N T R O L P R E C A U T I O N S
1 Isolation Required
2 Hand washing Required
3 Gloves Required
4 Apron Required
5 Mask Required
6 Eye protection Not required
The risk of transmission is minimal after 3 weeks of illness, but in a few cases (up to 20%)
infectivity can persist for up to 6 weeks. Therefore the above infection control precautions
should be taken in all hospitalised cases. Discuss with your Infection Prevention and Control
Team if required.
S TA F F All staff looking after a patient with whooping cough should have had a full
course of whooping cough vaccination. If vaccination history is incomplete or unknown,
arrange for other staff to care for the patient and discuss with Occupational Health.
VI S I T O R S Visitors should be kept to a minimum number and should be limited to adults
with a history of vaccination against whooping cough. Children under the age of 1 year
should not visit under any circumstances. Visitors should comply with all above
precautions.
PAT I E N T T R A N S F E R Patient transfer should be kept to a minimum. The patient should
wear a mask during transfer. The receiving ward/department should be informed in advance
of the diagnosis.
MORE INFORMAT I O N Whooping cough may occur at any age. Young infants are
the most at risk because they are not yet vaccinated and because infection at this age can
cause severe illness with breathing difficulties.
Epidemics of whooping cough occur every 3 to 4 years, and the highest number of cases
is usually in July–September annually.
Whooping cough is a vaccine-preventable disease. In the UK it is given as part of the
routine childhood immunisation programme and is also given to high-risk groups as
needed, e.g. to pregnant women during the 2012–2013 national outbreak. Immunity
wanes over time and it is possible to catch whooping cough even if you have previously had
the illness or a course of vaccinations.
The illness begins with coryzal symptoms and progresses to a dry cough, which may
occur in paroxysms (outbursts of coughing) and may end with vomiting or with an intake
of air, which makes a ‘whooping’ sound. The cough may go on for weeks or months

Whooping cough is treated with antibiotics (usually erythromycin, clarithromycin or
azithromycin) within the first 3 weeks of symptoms. Treatment is not necessary later in the
course of the illness. Treatment duration used to be 14 days but has now been reduced
to 7 days (3 days if taking azithromycin). Unvaccinated/partially vaccinated cases up to
10 years of age should complete their course of primary immunisation and booster vaccine
once they have recovered from their acute illness.
Contacts of cases may be offered antibiotic prophylaxis and/or vaccination if identified
promptly.
Laboratory confirmation is possible by culture or PCR of pernasal swab or nasopharyngeal
aspirate, or by serology. Discuss with your microbiologist or Health Protection Unit to
ascertain the most appropriate test.